Montana Code 53-6-143. Medical assistance liens and recoveries
53-6-143. Medical assistance liens and recoveries. (1) Except as provided in this section, the department may not impose a lien upon the property of an applicant for or recipient of medical assistance.
Terms Used In Montana Code 53-6-143
- Applicant: means a person:
(a)who has submitted an application for determination of medicaid eligibility to a medicaid agency on the person's own behalf or on behalf of another person; or
(b)on whose behalf an application has been submitted. See Montana Code 53-6-155
- Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
- Claim: means a communication, whether in oral, written, electronic, magnetic, or other form, that is used to claim specific services or items as payable or reimbursable under the medicaid program or that states income, expense, or other information that is or may be used to determine entitlement to or the rate of payment under the medicaid program. See Montana Code 53-6-155
- Department: means the department of public health and human services provided for in 2-15-2201. See Montana Code 53-6-155
- Lien: A claim against real or personal property in satisfaction of a debt.
- Medicaid: means the Montana medical assistance program established under Title 53, chapter 6. See Montana Code 53-6-155
- Person: includes a corporation or other entity as well as a natural person. See Montana Code 1-1-201
- Personal property: All property that is not real property.
- Personal property: means money, goods, chattels, things in action, and evidences of debt. See Montana Code 1-1-205
- Property: means real and personal property. See Montana Code 1-1-205
- Recipient: means a person:
(a)who has been determined by a medicaid agency to be eligible for medicaid benefits, whether or not the person actually has received any benefits; or
(b)who actually receives medicaid benefits, whether or not determined eligible. See Montana Code 53-6-155
- Recoverable medical assistance: means a payment pursuant to this part, including but not limited to a payment made for items or services provided to and insurance premiums, deductibles, and coinsurance paid on behalf of a recipient who:
(i)during the recipient's lifetime, was an inpatient in a nursing facility, intermediate care facility for the developmentally disabled, or institution for mental disease and, with respect to that institutionalization, the department determined under 53-6-171 that the person was not reasonably expected to be discharged and return home; or
(ii)was at least 55 years of age or younger if allowed by 42 U. See Montana Code 53-6-165
- Recovery: means legal action brought for the payment or repayment of recoverable medical assistance or amounts of money paid for other purposes. See Montana Code 53-6-165
(2)A lien for recovery of medical assistance paid or to be paid under this chapter may be imposed against the real or personal property of a medicaid applicant or recipient prior to the applicant’s or recipient’s death only:
(a)pursuant to a judgment of a court for recovery of medical assistance paid on behalf of the recipient;
(b)on a third-party recovery as provided in 53-2-612;
(c)as provided in 53-6-171 through 53-6-188; or
(d)to the extent that the recipient has received medical assistance based upon resources not disregarded pursuant to part 8 of this chapter.
(3)The department may recover medical assistance correctly paid on behalf of a recipient only as provided in 53-2-612, 53-6-167 through 53-6-169, or 53-6-171 through 53-6-188 or as provided in a written agreement between the department and the recipient or the recipient’s representative pursuant to 42 U.S.C. § 1382b(b).
(4)Except as otherwise specifically provided by 53-6-144, 53-6-165 through 53-6-169, 53-6-171 through 53-6-189, and this section, the department may pursue recovery under any section or combination of sections as may be applicable in a particular case. However, the department may not recover pursuant to 53-6-167 through 53-6-169 or 53-6-171 through 53-6-188 more than the total amount of recoverable medical assistance paid on behalf of a recipient, plus any applicable costs, interest, or other charges specifically allowed by law. The fact that the department has or may have a lien on particular property does not preclude the department from pursuing recovery under another section against other assets of the recipient or assets of another person as provided in 53-6-144, 53-6-165 through 53-6-169, 53-6-171 through 53-6-189, and this section.
(5)Except as provided in subsections (5)(a) and (5)(b), the department may not impose a lien under this section upon a self-sufficiency trust established pursuant to Title 53, chapter 18, part 1, or upon the assets of a self-sufficiency trust established pursuant to Title 53, chapter 18, part 1.
(a)The department may impose a lien under this section upon a self-sufficiency trust or upon the assets of a self-sufficiency trust established pursuant to Title 53, chapter 18, part 1, if the department is required by federal law to recover or collect from the trust or its assets as a condition of receiving federal financial participation for the medicaid program.
(b)To the extent otherwise permitted by this section, the department is not precluded from asserting a claim or imposing a lien upon real or personal property prior to transfer of the property to the trust. If the department imposes a lien upon property prior to transfer to a self-sufficiency trust, any transfer of the property to the trust is subject to the lien.